The Compendium of Caraka 3.8: aṣṭamo 'adhyāyaḥ/

Now we shall expound the specific determination concerning diseases and the remedies of physicians.

Thus spoke the venerable Ātreya.

An intelligent person wishing to become a physician, having understood through rational insight the gravity or lightness of his duties, the fruit of actions, the subsequent consequences, and the place and time, should first examine the authoritative treatise itself.

For various treatises of physicians circulate in the world; there, that treatise which he considers to be very great, cultivated by renowned and steadfast persons, rich in substance, honored by authoritative experts, beneficial to the intellect of the three kinds of pupils, free from the fault of repetition, composed by ṛṣis, with a well-ordered succession of aphorisms, commentaries, and summaries, sound in its basis, devoid of degraded words, free from obscure words, full in terminology, with orderly meanings, centered on the determination of the real nature of things, coherent in sense, uncluttered in subject matter, quick to enlighten, and endowed with definitions and examples—to that treatise he should apply himself.

For such a treatise, like a spotless sun dispelling darkness, illuminates everything.

Immediately after that, he should examine the teacher, namely: one who has fully purified knowledge of the scriptures, who has observed clinical practice, who is skilled, dexterous, pure, of practiced hand, equipped with instruments, endowed with all intact sense faculties, knowing human nature, knowing appropriate action, whose knowledge is unadulterated, unarrogant, free from malice, not prone to anger, capable of enduring hardship, affectionate toward his students, an able teacher, and capable of imparting understanding.

For a teacher endowed with such qualities quickly endows a good student with the qualities of a physician, just as a seasonal cloud endows a good field with the qualities of grain.

Approaching him with a desire to please him, he should serve him unremittingly like fire, like a deity, like a king, like a father, and like a master.

Then, through his grace, having comprehended the entire treatise, he should strive repeatedly and thoroughly for firmness in the treatise, excellence in terminology, understanding of meaning, and eloquence of speech.

In this matter we shall explain the means: study, teaching, and discussion with specialists are the means.

Here, this is the rule for study: in good health, having set aside time, rising early in the morning or at the break of dawn, having attended to the calls of nature and performed ablutions with water, having bowed to the deities, ṛṣis, cows, brahmins, elders, seniors, siddhas, and teachers, seated comfortably in a level, clean place, repeating the aphorism with speech preceded by mental focus, he should recite it again and again, understanding and thoroughly penetrating the true nature of the subject matter, for the purpose of removing his own faults and establishing the faults of opponents; thus at midday, in the afternoon, and at night, he should practice his study constantly without slacking.

This is the rule of study.

Now the rule for teaching: a teacher who has resolved upon teaching should first examine the pupil, namely: peaceful, noble by nature, not engaging in base actions, with straight eyes, mouth, and bridge of the nose, with a thin, red, and clean tongue, with undeformed teeth and lips, not nasal-speaking, resolute, free from arrogance, intelligent, endowed with reasoning and memory, of noble temperament, born into a family of that science or observing the conduct of that science, devoted to the truth, devoid of deformity, with faculties not impaired, modest, not haughty, contemplating the true nature of things, free from anger, free from vices, endowed with character, cleanliness, good conduct, affection, competence, and dexterity, desirous of study, having no other business in understanding the meaning and observing practical work, ungreedy, not indolent, wishing the welfare of all beings, obedient to all instructions of the teacher, and affectionate—one who is endowed with such qualities, they say, is fit to be taught.

To such an applicant for study, who has approached him wishing to please him, the teacher should say: 'During the northern course of the sun, in the bright fortnight, on an auspicious day, when the revered moon is in conjunction with any of the asterisms Tiṣya, Hasta, Śravaṇa, or Aśvayuj, in an auspicious karaṇa and a Maitra muhūrta, having your head shaved, having fasted, having bathed, clad in an ochre-colored garment, with fragrant hands, you should present yourself taking fire-sticks, fire, ghee, plastering material, water jars, flower garlands, lamps, gold, silver, gems, pearls, coral, linen enclosures, kuśa grass, puffed grain, mustard seeds, unbroken grains, white flowers—both strung and unstrung—pure edible items, and ground fragrances.'

He should do so.

Having known him to be present, [the teacher,] in an even and clean place sloping toward the east or sloping toward the north, having made an altar measuring four kiṣkus, square, smeared with cow dung and water, strewn with kuśa grass, well enclosed on all four sides with fencing sticks, adorned with sandalwood, water jars, linen, gold, silver, gems, pearls, and coral as described, and graced with wholesome edible foods, perfumes, white flowers, parched grain, mustard seeds, and unbroken grains; having established the fire there with fire-sticks of palāśa, ingudī, udumbara, or madhūka; facing east, pure, and having complied with the rule for study, should offer oblation three times each into the fire with honey and ghee with mantras endowed with blessings, addressing first Brahmā, Agni, Dhanvantari, Prajāpati, the two Aśvins, Indra, and the ṛṣis who are authors of the sūtras, saying: 'svāhā'.

And the pupil should hold on to him.

And having offered the oblation, he should circumambulate the fire keeping it to the right.

Having circumambulated, he should cause the Brahmins to pronounce blessings; and he should worship the physicians.

Then, in the presence of the fire, in the presence of the Brahmins, and in the presence of the physicians, he should instruct him: 'You must be a celibate student, wear a beard, speak the truth, not eat meat, consume wholesome food, be free from envy, and bear no weapons. And no improper act should be done by you on my word, except what is hated by the king, what takes life, or a matter that is exceedingly unrighteous or attended with misfortune. You must always be devoted to me, hold me foremost, be dependent on me, and pursue what is dear and beneficial to me. Serving like a son, like a servant, and like a petitioner, you should live near me. Without arrogance, attentive, with an undistracted mind, disciplined, acting after careful reflection, free from maliciousness, and permitted, you should conduct yourself. Conducting yourself whether permitted or unpermitted, you should first strive to your utmost to procure what the teacher requires. Desiring success in your work, attainment of wealth, acquisition of fame, and heaven after death, you, as a physician, should pray for the welfare of all living beings, beginning with cows and Brahmins, day by day, while rising and sitting. And you should strive with your whole soul for the recovery of the sick; and even for the sake of your life you must not harbor malice toward the sick. Even in mind you must not approach another’s wife or any of another’s property. You should have a modest dress and attire; you must not be a drunkard, not be sinful, and not have sinful companions; you must speak words that are gentle, pure, righteous, auspicious, blessed, true, beneficial, and measured; you should deliberate upon place and time, be mindful, and constantly make effort regarding the excellence of knowledge, initiative, and equipment. And you must never prescribe medicine to those who are hated by the king or hate the king, or to those who are hated by the public or hate the public; likewise, to all those of exceedingly base, corrupt, and wretched disposition, conduct, and behavior, to those who do not retaliate against reproach, and to those who are about to die; likewise also to women when their master is not present or who are without an overseer. And you must never accept any gift given by a woman without permission from her husband or overseer. And entering the home of a patient, accompanied by a known person who is permitted to enter, well-clad, with your head bowed, mindful, calm, and acting in everything with a mind that reflects carefully, you should enter properly. And having entered, your speech, mind, intellect, and senses must not be directed to anything else than the patient, the purpose of helping the patient, or other matters pertaining to the patient. And the affairs of the patient's family must not be divulged outside. And even knowing that the span of the patient’s life is diminished, you must not describe it there where, being spoken, it leads to injury to the patient or to another. And even though possessing knowledge, you should not boast exceedingly of your knowledge; for many are exceedingly repelled even by an authoritative person who boasts.'

'For there is indeed no absolute end to Āyurveda; therefore, unremitting, one should constantly pursue application to it. And this must be done: further excellence of conduct should be acquired without jealousy even from others. For the entire world is a teacher to the wise, and an enemy to the unwise. Hence, considering this, the wise person should listen to and comply with words even of an enemy that are auspicious, fame-bringing, lifespan-prolonging, nourishing, and practical as he instructs.'

Beyond this he should say: 'You must always conduct yourself properly toward deities, fire, Brahmins, teachers, elders, accomplished sages, and preceptors. As you conduct yourself properly toward them, this fire, all scents, tastes, gems, seeds, and the deities as mentioned will be auspicious to you; conducting yourself otherwise, inauspicious.'

And when the preceptor speaks thus, the pupil should say: 'So be it.'

And acting according to the instruction, he is fit to be taught; otherwise, he is unfit to be taught.

For a preceptor who teaches one who is fit to be taught attains connection with the fruits of teaching as described, and endows his pupil and himself with other qualities leading to the highest good that have not been mentioned.

Thus the rule for teaching has been stated.

Henceforth we shall explain the rule for discussion: a physician should discuss with a physician.

For discussion with specialists produces enthusiastic application to knowledge, brings about clarity, confers power of speech, illuminates fame, removes doubt regarding what was previously heard through hearing it again when one had doubts, produces greater conviction regarding what was heard when one had no doubts, and brings even an unheard matter to the domain of hearing. Moreover, that collection of secret and favored teachings which a preceptor imparts gradually to an obedient and pleasing pupil, one who desires victory says in a nutshell out of enthusiasm while debating with one another. Therefore, the skilled praise discussion with specialists.

Now, discussion with specialists is indeed of two kinds: friendly discussion and hostile discussion.

Among them, friendly discussion is prescribed with one endowed with knowledge, specialized understanding, and the power of statement and rejoinder, free from anger, possessing uncorrupted knowledge, unmalicious, amenable to reason, skilled in reasoning, capable of enduring hardship, and speaking pleasantly.

Speaking with such a person, one should speak with confidence and inquire with confidence; to one inquiring with confidence, one should state the matter clearly. One should not become anxious out of fear of defeat, nor should one rejoice upon defeating him. One should not boast before others, nor cling obstinately to one side out of delusion, nor describe a matter that is not understood. One should conciliate properly with reasoning, and remain attentive in that [discussion].

Thus ends the rule for agreeable discussion.

Hereafter, engaging in hostile discussion with another, one should debate while discerning one's own advantage.

Even before the debate, one should properly examine the nature of the debate, the disparity between the superior and the inferior, and the distinctions among assemblies.

For proper examination indicates to the intelligent the proper time for engaging in or desisting from an undertaking; therefore, the skilled praise examination.

Now, examining the disparity between the superior and the inferior, one should properly examine these qualities of a debater that lead to excellence, as well as those that are defective. That is to say: learning, specialized knowledge, retention, presence of mind, and power of speech—these they declare to be the qualities that lead to excellence. These, on the other hand, are defective, namely: irritability, lack of clarity, timidity, lack of retention, and inattentiveness.

One should weigh these qualities in terms of their relative weight, both in the opponent and in oneself.

There, the opponent turns out to be of three kinds—superior, inferior, or equal—by virtue of the distribution of qualities, but not entirely so.

An assembly is indeed of two kinds: knowledgeable and ignorant.

That very assembly, though two-fold, is again three-fold according to this division of circumstances: a friendly assembly, an impartial assembly, and a biased assembly.

There, in a biased assembly—whether endowed with knowledge, specialized knowledge, and the power of statement and rejoinder, or ignorant—debate is by no means prescribed with anyone. In an ignorant assembly, however, whether friendly or impartial, debate is prescribed even with one devoid of knowledge, specialized knowledge, and the power of statement and rejoinder, whose fame has not shone forth, or who is detested by the populace.

Speaking with such a person, one should speak with complex sentences crowded with disjointed, prolonged strings of aphorisms; being excessively cheerful, laughing frequently, looking down upon the opponent, and indicating him to the assembly with gestures, one should grant him no opportunity to speak. When he utters a difficult word, one should say, 'It is not understood,' or else, 'Your thesis is defective.'

When challenged again, one should reply: 'Go study for a full year first; surely you have not served a teacher, or else this is enough for you. For even once cast down by encirclement, they say one is cast down!' In this manner, one should not engage with him at all.

Some say that one should speak in hostile debate even with a superior in this way; however, the skilled do not praise conflict with a superior.

Debating hostiles with an inferior or with one considered an equal, one should speak in a friendly assembly, or in an impartial assembly endowed with attentiveness, the ability to listen, knowledge, specialized understanding, comprehension, and the power of statement and rejoinder. While speaking attentively, one should observe the opponent's strength in good qualities and defects; having observed, one should not engage him in debate where one considers him superior, keeping one's non-engagement concealed; where one considers him inferior, however, there alone one should swiftly defeat him.

There, these are indeed the means for swiftly defeating inferiors; that is to say: one should overcome one lacking in learning by extensive recitation of aphorisms; one lacking in specialized knowledge, by speech containing difficult words; one lacking in retention of speech, by complex sentences crowded with disjointed, prolonged strings of aphorisms; one lacking in presence of mind, by ambiguous speech that conveys multiple meanings; one lacking in power of speech, by interrupting a half-spoken sentence; one lacking clarity, by humiliation; one prone to anger, by exhaustion; the timid, by intimidation; and the inattentive, by strict restriction.

Thus, by these means, one should swiftly overcome an inferior opponent.

On this point, there are two verses:

One should speak in a hostile manner with reasoning, and not reject what is reasoned; / for hostile speech indeed produces severe enmity in some.

There is nothing that should not be done for one who is angry, nor is there anything that should not be said.

The skilled do not applaud a quarrel in an assembly of the virtuous.

When a debate has thus begun, one should act [as follows]:

Even beforehand, one should strive to do this: having formed an alliance with the assembly, a topic that serves as one's own advantage should be pointed out, or one that would be exceedingly difficult for the opponent; or else, one should turn the assembly completely away from the opponent's position. When the assembly has been won over, one should remain silent after saying: 'It is impossible for us to speak; this assembly itself will establish the debate and the rules of debate according to its pleasure, appropriateness, and intention.'

In this matter, this is the definition of the rules of debate: 'This may be said, this may not be said; in this manner, one becomes defeated.'

Now, these terms are indeed to be mastered for the sake of knowing the path of debate for physicians; that is to say: debate, substance, qualities, action, generality, particularity, inherence, proposition, establishment, counter-establishment, reason, example, application, conclusion, rejoinder, established tenet, verbal testimony, direct perception, inference, tradition, analogy, doubt, purpose, erratic reasoning, inquiry, ascertainment, presumption, probability, question-worthy, not question-worthy, questioning, counter-questioning, flaw of speech, excellence of speech, quibble, non-reason, mistimed statement, objection, refutation, abandonment of proposition, concession, shift of reason, shift of topic, and point of defeat.

There, 'debate' is that in which one speaks hostily with an opponent based upon authoritative treatises. In summary, it is of two kinds: disputation and cavil.

There, disputation is the speech of two parties adhering to opposing sides, and cavil is the contrary of disputation.

For instance: the thesis of one is 'Rebirth exists,' and of the other, 'It does not exist.' Both establish their own respective theses with reasons for their own sides and refute the other's thesis—this is disputation.

Cavil is the contrary of disputation.

Cavil consists merely of stating flaws in the opposing side.

Substance, quality, generic attribute, particularity, and inherence have already been stated with their individual definitions in the Ślokasthāna.

Now, the proposition: a proposition is the statement of what is to be proved; for instance, 'The self is eternal.'

Now, the establishment: establishment is the establishing of that very proposition by means of reason, example, application, and conclusion.

For first comes the proposition, and afterwards the establishment; for what can one establish if it is unproposed? For instance: 'The self is eternal' is the proposition; reason: 'because it is unproduced'; example: 'like space'; application: 'and just as space is unproduced and eternal, so is the self'; conclusion: 'therefore, it is eternal.'

Now, the counter-establishment: counter-establishment is establishing the contrary sense of that very proposition of the opponent.

For instance: 'The self is non-eternal' is the proposition; reason: 'because it is perceptible by the senses'; example: 'like a pot'; application: 'just as a pot is perceptible by the senses and is non-eternal, so is this [self]'; conclusion: 'therefore, it is non-eternal.'

Now, the reason: a reason is the means of apprehension; it is perception, inference, authoritative tradition, and comparison; that which is apprehended by these reasons is reality.

Now, the example: an example is that in which the understanding of both the foolish and the learned is equal, and which illustrates what is to be illustrated.

For instance: fire is hot, water is fluid, earth is firm, the sun is illuminating; just as the sun is illuminating, so the knowledge of Sāṃkhya is illuminating.

Application and conclusion have already been stated in the explanation of establishment and counter-establishment.

Now, the counter-argument: a counter-argument is the statement of dissimilarity when a reason has been stated through similarity, or the statement of similarity when a reason has been stated through dissimilarity.

For instance, to one who says: 'Diseases share the nature of their cause, for in a cold disease the similarity with the causes consists in contact with snow, cold weather, and wind,' an opponent might say: 'Diseases have a dissimilar nature to their cause, just as in the burning sensation, heat, putrefaction, and suppurative sloughing of body parts, the dissimilarity to the cause consists in contact with snow, cold weather, and wind.'

This, along with its converse, is the counter-argument.

Now, the established tenet: an established tenet is a determination that is established after being examined in various ways by investigators and proved by reasons.

It is of four kinds: a tenet common to all systems, a tenet peculiar to one system, an implied tenet, and a hypothetical tenet.

Among them, a tenet common to all systems is that which is established across every respective system; for instance: causes exist, diseases exist, and means of cure for curable [diseases] exist.

A tenet peculiar to one system is that which is established only in a particular system; for instance: in another [treatise] there are eight tastes, but here six; here there are five sense organs, but in another treatise six sense organs; as in another [treatise] all disorders are caused by vāta and the rest, whereas here they are established as caused by vāta and the rest and caused by bhūtas.

An implied tenet is one where, when a given subject is being established, other subjects are established as well; for instance, when it is established that 'One who is liberated does not perform action that binds, because he is free from desire,' the fruits of action, liberation, the self, and life after death are established.

A hypothetical tenet is that matter which physicians accept at the time of debate although it is unproved, unexamined, untaught, or devoid of reason; as in: 'Assuming that substance is primary, we shall explain,' 'Assuming that qualities are primary, we shall explain,' 'Assuming that potency is primary, we shall explain,' and so forth.

Thus is the fourfold established tenet.

Now, verbal testimony: verbal testimony is a collection of sounds. It is of four kinds: referring to perceptible matters, referring to imperceptible matters, true, and false.

Among them, that referring to perceptible matters is: the doshas are aggravated by three causes, and they are pacified by six therapeutic measures; when the auditory and other faculties exist, there is apprehension of sound and other objects.

Again, that referring to imperceptible matters is: life after death exists, liberation exists.

True is that which corresponds to reality; [for instance:] the teachings of Āyurveda exist, the means of curing curable diseases exist, the fruits of therapeutic action exist.

And the contrary of the true is false.

Now, perception: perception is that which is apprehended by oneself through the self and through the senses. Among them, pleasure, pain, desire, aversion, and the like are perceptible by the self, whereas sound and the like are perceptible by the senses.

Now, inference: inference is reasoning dependent on logical connection; for instance, [inferring] the digestive fire by the power of digestion, strength by the capacity for exercise, and the sense of hearing and the others by the apprehension of sound and other objects, and so on.

Now, authoritative tradition: authoritative tradition is the instruction of authoritative persons, such as the Veda.

Now, comparison: comparison is an explanation based on the similarity of one thing to another; for instance, [describing] daṇḍaka through a staff, tetanus through a bow, and one who confers health through an archer.

Now, doubt: doubt is irresolution regarding matters that are accompanied by signs causing uncertainty; for instance, seeing persons endowed with the marks of longevity and not endowed with them, as well as those receiving treatment and not receiving treatment, perishing quickly or living long, because both are seen there is doubt: 'Does untimely death really exist or does it not?'

Now, purpose: purpose is that for the sake of which undertakings are begun; for instance: 'If untimely death exists, then I shall care for myself with life-promoting measures and avoid non-life-promoting ones; how could untimely death overpower me?'

Now, erratic reasoning: erratic reasoning is that which errs; for instance: 'Might this medicine be suitable in this disease, or not?'

Now, inquiry: inquiry is examination; as will be taught later in the examination of medicaments.

Now, decisive judgment: decisive judgment is certainty; for instance: 'This disease is purely due to vāta, and this indeed is its medicine.'

Now, implication: implication is where, by one meaning being stated, another unstated meaning is also established. For instance, when it is said, 'This disease is not curable by nourishing therapy,' the implication is: 'This is curable by depleting therapy.' When it is said, 'He should not eat by day,' the implication is: 'He should eat at night.'

Now, source: that from which something arises is its source; for instance: the six elements are [the source] of the embryo, the unwholesome of disease, and the wholesome of health.

Now, the questionable: the questionable is a statement that is accompanied by a defect of statement.

Or, when things are spoken of generally, a statement made to grasp the specific distinction is also questionable. For instance: when it is said, 'This disease is curable by purification,' it is questioned: 'Is it curable by emesis, or is it curable by purgation?'

Now, the unquestionable: the unquestionable is the opposite of this; for instance: 'This is incurable.'

Now, questioning: questioning is when, among specialists with specialists, an inquiry or part of an inquiry into a treatise or a part of a treatise is directed in order to test their theoretical knowledge, practical knowledge, speech, and rejoinder.

For instance, when the proposition 'The self is eternal' is made, that which the opponent says—'What is the reason?'—is questioning.

Now, counter-questioning: counter-questioning is questioning the question; for instance: 'What again is the reason for this question?'

Now, defect of statement: defect of statement in this subject is: the deficient, the superfluous, the meaningless, the incoherent, and the contradictory; for without these, the subject under discussion would not be ruined.

Among them, the deficient: it is deficient if it is lacking even in one among the proposition, reason, example, application, and conclusion; or when a thesis taught with many reasons is substantiated with only one reason, that too is deficient.

Now, the superfluous: the superfluous is the opposite of the deficient; or, while Āyurveda is being discussed, if something from the treatise of Bṛhaspati or of Uśanas, or anything else unconnected in meaning, is uttered; or if even a connected meaning is stated twice, that is superfluous because of the defect of repetition. And that repetition is of two kinds: repetition of meaning and repetition of words. Among them, repetition of meaning is like: 'bheṣaja, auṣadha, sādhana' [all meaning medicine]; whereas repetition of words is like: 'bheṣaja, bheṣaja'.

Now, the meaningless: the meaningless is a statement that consists merely of a group of letters, like the five consonant groups, and is not apprehended in terms of meaning.

Now, the incoherent: the incoherent is that which has meaningful words, but their meanings are not connected with one another; for instance: 'wheel, crocodile, bamboo, thunderbolt, moon.'

Now, the contradictory: the contradictory is that which conflicts with examples, established tenets, or conventions. Among these, examples and established tenets have been mentioned earlier. Convention, moreover, is threefold; namely: medical convention, sacrificial convention, and liberation-treatise convention. Among them, medical convention is: 'Medicine has four limbs'; sacrificial convention is: 'Animals are to be slaughtered by the sacrificers'; liberation-treatise convention is: 'Non-violence towards all living beings.' There, what is stated contrary to one's own convention is contradictory.

These are the defects of statement.

Now, excellence of statement: excellence of statement in this subject is that statement which is praised as unquestionable because it is non-deficient, non-superfluous, meaningful, non-incoherent, non-contradictory, and has readily understood word-meanings.

Now, quibble: quibble is deceitful, an appearance of sense, meaningless, and a mere verbal contrivance.

It is of two kinds: verbal quibble and generalization quibble.

Among them, verbal quibble is, for instance, if someone should say: 'This physician is nava-tantra [possessing nine treatises, or novice in treatises]'; then the physician should say: 'I am not nava-tantra [possessing nine treatises]; I follow one treatise.' The opponent should say: 'I did not say you have nine treatises, but rather that the treatise was studied newly [nava] by you.' The physician should say: 'The treatise was not studied newly by me; the treatise has been studied many times by me.' This is verbal quibble.

Generalization quibble is, for instance: when it is said, 'Medicine is for pacifying disease,' the opponent says: 'Why do you say that an existent thing is for pacifying an existent thing? For disease is an existent thing, and medicine is an existent thing; and if an existent thing is for pacifying an existent thing, then cough being an existent thing, and wasting being an existent thing, because of their shared existence, cough would pacify your wasting.' / This is generalization quibble.

This is generalization quibble.

Now, the non-reason: the non-reason is 'equal to the question', 'equal to the doubt', and 'equal to the subject to be proved'.

Among them, the non-reason named 'equal to the question' is, for instance: 'The self is eternal because it is distinct from the body.' The opponent might say: 'Since the self is distinct from the body, therefore it is eternal; for the body is non-eternal, so the self must possess the opposite property.' And this is a non-reason; for the thesis itself is not the reason.